Human Sexuality- Chapter 6

Human Sexuality

Chapter 6: Birth Control, Contraception, and Abortion

Overview

  • This chapter delves into the various methods of birth control and their historical contexts, legal implications, and practical applications.

  • Discussion includes both contraception and abortion, providing a comprehensive view of reproductive health.

A. History of Birth Control

  • Long History:

    • Contraception has been practiced for hundreds of years.

    • Common Historical Methods:

    • Barrier methods like condoms and diaphragms.

    • Use of herbal abortifacients and early forms of induced abortion.

  • Early 20th Century Innovations:

    • Intrauterine Device (IUD) invented in the 1920s.

    • Diaphragms were the predominant female-controlled contraceptive until the 1960s.

    • Game Changer: The advent of “The Pill” revolutionized birth control methods.

B. Interesting Historical Fact

  • Did You Know?:

    • In the 1800s, users of early condoms would blow into them to check for holes and ensure they were intact before use.

C. Feminist Advocacy & Birth Control Legalization

  • Margaret Sanger's Advocacy:

    • Championed the fight to legalize contraception.

    • Founded the first birth control clinic in 1916 in Brooklyn, which eventually evolved into Planned Parenthood.

  • Key Legal Decisions (1960s & 70s):

    • Griswold v. Connecticut (1965):

    • Supreme Court invalidated a state law that banned contraceptives for married couples, establishing a constitutional right to privacy.

    • Eisenstadt v. Baird (1972):

    • Expanded the right to unmarried individuals, ruling laws prohibiting contraceptive distribution to unmarried people unconstitutional.

D. Contraception Methods Available in College

  • Types of Contraceptives:

    • Male condoms.

    • Contraceptive pills.

    • Withdrawal method.

    • Intrauterine device (IUD).

    • Implantable devices.

    • Emergency contraception.

    • Fertility awareness techniques.

    • Patch, injection, and ring methods.

    • Sterilization options and other methods.

E. Physical Methods of Birth Control
1. Male Condoms

  • Description:

    • A barrier method that prevents sperm from entering the vagina.

    • When used correctly and consistently, they are highly effective at preventing pregnancy and also protecting against STIs, including HIV.

  • Materials & Sizes:

    • Made from latex, polyurethane, polyisoprene, and lambskin.

    • Available in various sizes and textures to enhance comfort and fit.

    • Only latex, polyurethane, and polyisoprene varieties protect against STIs.

2. Instructions for Using Male Condoms

  1. Open the condom pack carefully. Use a new condom for each act of intercourse if there is any risk of pregnancy or STI.

  2. Place the condom on the erect penis tip with the rolled side out before any genital contact.

  3. Unroll the condom down to the base of the penis.

  4. After ejaculation, hold the rim of the condom and withdraw the penis while still erect.

  5. Discard the used condom safely in the trash (not the toilet).

  6. With latex condoms, use only water-based or silicone-based lubricants to prevent breakage.

3. Internal (Female) Condoms

  • Description:

    • A barrier method that lines the vaginal canal or rectum, blocking sperm.

    • Worn internally, empowering the receptive partner with control over protection.

    • Made from synthetic nitrile or latex.

4. Diaphragms & Cervical Caps

  • Diaphragms:

    • A soft, flexible cup covering the cervix, blocking sperm entry into the uterus.

    • Must be used with spermicide to kill any sperm that may circumvent the diaphragm edges.

    • Requires professional fitting for proper size and placement.

  • Cervical Caps:

    • A smaller version that creates a suction seal on the cervix.

    • Can be worn for up to 48 hours, but may displace during intercourse, particularly in women who have had vaginal births.

5. Spermicides

  • Description:

    • Chemicals (commonly nonoxynol-9) that kill or disable sperm.

    • Available in various forms such as gels, foams, films, suppositories, and creams.

  • Limitations:

    • Not reliable as a standalone method, often used with other barrier methods.

    • High failure rate when used alone, with no protection against STIs.

F. Intrauterine Devices (IUDs)

  • Description:

    • A T-shaped device inserted into the uterus to prevent pregnancy.

    • Mechanisms of action include thickening cervical mucus and inhibiting sperm, and sometimes preventing ovulation.

  • Types:

    • Hormonal IUDs.

    • Copper IUDs.

  • Pros:

    • Over 99% effective.

    • High convenience, termed as "set it and forget it."

    • Fertility returns quickly post-removal.

  • Cons:

    • No protection against STIs.

    • Risk of expulsion or perforation (although rare).

    • Possible risk of ectopic pregnancy if pregnancy occurs.

    • Requires professional insertion and removal.

G. Hormonal Methods
Hormone-Based Contraceptive Pills

  • Types:

    • Combination pills (contain estrogen and progestin).

    • Progestin-only pills (known as the "mini-pill").

  • Mechanism of Combined Pills:

    • Inhibit pituitary hormones that prevent follicle maturation and ovulation.

    • Thicken cervical mucus to prevent sperm entry into the uterus.

    • Thin the uterine lining to hinder implantation, serving as a secondary effect.

Non-Oral Hormonal Administration

  1. Transdermal Patches:

    • Contain estrogen and progestin.

    • Applied to the skin once a week for 3 weeks, followed by one patch-free week.

    • Functions similarly to combination pills by preventing ovulation and thickening cervical mucus.

  2. Vaginal Rings:

    • Flexible ring inserted into the vagina.

    • Releases estrogen and progestin continuously for three weeks.

    • Removed for one week before inserting a new ring, ensuring steady hormone levels with fewer daily management concerns.

H. Behavioral Methods
Overview

  • Can be more challenging to implement effectively.

  • Standard Days Method:

    • Tailored for women with regular 26–32 day cycles, utilizing cycle beads to track fertile days.

  • Fertility Awareness:

    • Monitors changes in cervical mucus and basal body temperature to identify fertile windows.

  • Withdrawal Method:

    • Simple but unreliable since pre-ejaculate may contain sperm, making timing crucial.

  • Noncoital Sex (Outercourse):

    • Engaging in sexual activities that do not involve vaginal penetration to prevent pregnancy.

I. Emergency Contraception (EC)

  • Description:

    • High-dose pills intended for consumption after unprotected sex to mitigate pregnancy risk.

  • Types of Emergency Contraceptive Pills:

    • Plan B One-Step:

    • Contains progestin.

    • Prevents ovulation and can reduce pregnancy risk by 60%–90%.

    • Available over-the-counter to individuals of all ages.

    • Ella:

    • Contains a progesterone blocker.

    • Works to prevent ovulation for up to 5 days post-intercourse.

    • Requires a prescription and is generally more expensive.

  • IUD Insertion:

    • Can be inserted within 5 days of unprotected sex, preventing implantation and considered the most effective EC method.

J. Safe Abortion Procedures
1. Induced Abortion

  • Definition:

    • The intentional termination of a pregnancy.

  • Types:

    • Spontaneous Abortion (Miscarriage): Pregnancy ends naturally.

    • Therapeutic Abortion: Conducted to protect the mother’s health.

    • Elective Abortion: Executed for personal or non-medical reasons.

2. Reasons for Abortion (by percentage of women)

  • Not ready for a(nother) child; timing is wrong: 25%

  • Can’t afford a baby now: 23%

  • Completed my childbearing; have other dependents; children are grown: 19%

  • Don’t want to be a single mother; relationship problems: 8%

  • Don’t feel mature enough to raise a(nother) child; feel too young: 7%

  • Would interfere with education or career plans: 4%

  • Physical health problems: 4%

  • Possible fetal health issues: 3%

  • Victim of rape: <0.5%

  • Pressure from husband/partner to have an abortion: <0.5%

  • Pressure from parents to have an abortion: <0.5%

  • Don’t want to disclose sexual activity or pregnancy: <0.5%

  • Other reasons: 6%

K. Surgical and Medical Abortions
1. Surgical Abortions

  • Vacuum Aspiration:

    • Preferred method during the first trimester.

    • Most common abortion procedure in the U.S.

  • Dilation and Evacuation (D&E):

    • Used during the second trimester.

2. Medication Abortions

  • Description:

    • Utilize drugs to induce expulsion of the embryo typically within 7–9 weeks after the last menstrual period.

  • Mifepristone:

    • Blocks progestin receptors, leading to breakdown of the endometrium, and the embryo is no longer supported.

L. The Changing Legal Status of Abortion

  • Recent Changes:

    • In 2022, the Supreme Court (decision 6-3) overturned Roe v. Wade (1973), which had secured the right to abortion in the first trimester.

  • Significant Ruling:

    • Dobbs v. Jackson Women’s Health Organization ruled against recognizing a constitutional right to privacy in abortion matters.

  • Concerns:

    • This ruling raises prospects that related rights—including access to contraception and same-sex marriage—could be challenged in the future.